The third issue of our new all-colour magazine is proving popular with our supporters. Time to share some snippets with all our online visitors and subscribers!

Our cover story looked at the ancient Egyptian Queen Hatshepsut who had some very creative ideas about about death and dying, as well as embodying traditional ideas about persistence of identity over time and creating a positive attitude both to the dying process and to using mortality as an inspiration in life.

Many of the ancient Egyptian ideas about life and death are misrepresented, even by some Egyptologists, as ‘primitive’ or lacking in philosophy. The great French Egyptologist, Professor Claude Traunecker, suggested that these seemingly animalistic or unnecessarily complex religions were in fact allegory for reality. Key to their understanding is the two souls (each individual Egyptian had several), the ‘ka’ that stayed as the spirit of life and the ‘ba’ that contained the immortal essence.

We printed a warning about fake Nembutal, a hard-to-obtain sleeping drug, when it came to our attention that a number of people have parted with thousands of pounds or dollars to criminals offering it online. Some of the websites pose as right-to-die or pro-euthanasia sites’, even imitating the look of original sites in order to fleece people of their savings. Most customers never see anything for the money. No right-to-die society anywhere in the world sells Nembutal. (Purchasing it is also illegal.)

Dying is an art as well as a science. More than just the method you choose; or even that chooses you. It’s always good to have options. The time, the place, things that might affect your choice – such as mental or physical agility – or the degree of privacy (or lack of it!). We can’t guarantee your life but we try to explore every possible option, whether it is living longer or moving on from this life in a way that suits you best, and in a way that preserves as much dignity as possible. A unique thing about Exit is all our research is fully referenced.* You may read different ‘opinions’ from people with a high profile or claiming to be experts, but do they back up the evidence in a scholarly manner? (This means, do they provide exact references to the professional literature that shows peer-reviewed evidence as to how a particular drug tends to work in one way not in another way). We do this so we can be challenged and so science can move forward in a safe and responsible way. (If that sounds a bit too fussy, remember it is your life that is at stake!)

We printed a careful account of a failed suicide that someone had sent us, together with an extensive commentary. Failures are uncommon: but they are something from which we can learn. There are many ways of ending one’s life that might work. You may “know of someone who…” But what about the one that went wrong? We believe people learn best from honesty and accurate reporting. A failure might occur, for instance due to faulty materials, or last minute panic. Or combination drugs that worked in many cases but not in a particular individual. Scientific knowledge is your friend! We also reprinted a substantial paper written a little while ago on carbon monoxide* (from car exhausts) and how it used to be (fairly, only fairly) reliable in the days before catalytic converters but not now. We added an update on the Japanese craze of using charcoal burners with plusses and minuses and sources of further information.

We include further advice on advance directives (living wills). Not just on making one but on something we feel is very important if you possibly can, and that is talking to someone close to you about your wishes and who you trust to be supportive. Remember… you can refuse treatment even if you don’t have an Advance Directive (or Living Will) but it may help to have one. Be sure that you have listened to and understood all the implications, proposed treatments and medical outcomes before deciding. A general statement of wishes may be helpful in deciding what treatments you wish to refuse but if it is to have legal force it must be specific about which treatments are being refused and in what circumstances. In practice, it is very helpful if the person most likely to be contacted in an emergency is familiar with and supportive of your living will and also if you have discussed it with them in ordinary language. Talk about the sort of outcomes you would find acceptable or unacceptable. Without getting morbid about it chat about possibly scenarios. Just saying, “I wouldn’t want to be a vegetable” is not very helpful guidance, but if the medical team are honestly trying to respect your wishes (a legal requirement) then, in the midst of quite technical medical choices and difficult percentage-risks of different treatment options, finding out what is important to you can be a guide. Things like the degree of mental impairment you might consider acceptable or unacceptable, the degree of physical mobility and dexterity and so on.

Aletter to the bereaved is something most of us will have to write at one time or another. Do you maybe have ‘role models’ to bring to mind in such a situation? A surprising, and rather touching one we came across was no less than the ground-breaking physicist, Albert Einstein. In addition to discoveries which changed our understanding of time and fostered a common language of science, Einstein was also a person of enormous wisdom, empathy, and emotional intelligence. He wrote breathtaking love letters, counselled his young son on the secret to learning anything, assured a little girl who wanted to be a scientist but feared her gender would hold her back, and shared the secret of his genius with an inquisitive colleague. He corresponded with Freud on violence, peace, and human nature. But one of his most poignant and humane letters was addressed to Queen Elisabeth of Belgium, with whom he had cultivated a warm friendship. After the sudden death of her husband, King Albert, followed closely by the death of her daughter-in-law, Einstein reached out to offer thoughtful and tender solace to his bereaved friend … This excerpt is from a beautiful memoir by American author author Krista Tippett called, Einstein’s God: Conversations about Science and the Human Spirit …

Mrs. Barjansky wrote to me how gravely living in itself causes you suffering and how numbed you are by the indescribably painful blows that have befallen you.

And yet we should not grieve for those who have gone from us in the primes of their lives after happy and fruitful years of activity, and who have been privileged to accomplish in full measure their task in life.

Something there is that can refresh and revivify older people: joy in the activities of the younger generation — a joy, to be sure, that is clouded by dark forebodings in these unsettled times. And yet, as always, the springtime sun brings forth new life, and we may rejoice because of this new life and contribute to its unfolding; and Mozart remains as beautiful and tender as he always was and always will be. There is, after all, something eternal that lies beyond the hand of fate and of all human delusions. And such eternals lie closer to an older person than to a younger one oscillating between fear and hope. For us, there remains the privilege of experiencing beauty and truth in their purest forms.

We also gave readers articles by someone caring for a partner with a terminal illness and an anthropologist’s very human perspective into a different way of looking at death, a mention of our newly-released Conference Report Booklet, a section on inspirational quotes, tips on methods published in our books, and of course a good dash of humour as we have to remember to smile! Finally here’s a famous story you may know about form the history lessons; but history never quite brings out the human emotions of great life events very well. For that, we have somehow to “fill in the gaps”, to imagine, to use that imagination in a realistic way and perhaps learn from the experience.

The story of George

a dramatisation by Paula Singleton

His wife was holding his hand. She listened to the gurgle of his breathing. His eyes opened and caught hers, held them for a moment. She watched his forehead crease with the effort; his skin seemed waxy and strange. He had not been able to speak for some days but now his mouth fell open. He looked from his wife to their son who stood at her side.

“Goodbye” The word broke the thick silence between breaths. His eyelids slid down very slowly. The lines of effort faded. Yet still the terrible noise came and went. Came. Went.

Mary looked at the doctor.

“Dawson, he’s been ill for so many years.” Mary addressed the doctor who sat at the other side of the dark bed. “We do not wish him to have his life prolonged. He is near the end, is he not?”

Dawson took note of George’s pulse, weak against his own strong fingers.

“Yes ma’am, l believe so.”

He had been physician to George for many years, through good times and bad.

“Sometimes it gets on one’s nerves, I can tell you Dawson! ” A shadow of a smile passed over the doctor’s face as George’s voice rang out clear and humorous in his mind. “Sometimes these people seem to think one is made of stone and can go on for ever…”

Some hours passed. Edward or the doctor or Mary would shift a little every now and then. Only George remained motionless but for the flicker of the bedclothes with each struggle slower than the one before.

Mary still felt George ’s hand clammy in hers.

“How can he keep breathing?” she asked. “He is so weak, Dawson. How much longer?”

“I’m afraid that although he is in deathly coma, it could

be several hours before he breathes his last, ma’am. Every case is different but I have seen patients go on for many more hours before the mechanical end.”

He watched her hair bow towards the bed, her son’s knuckles white against her trembling shoulder. George’s lips fluttered as another breath limped from the tired lungs. The doctor produced a syringe and gently pressed it into George ’s neck.

“What are you doing?” George’s son whispered.

“It’s morphia and cocaine. His heartbeat will just stop. He will feel nothing.”

Mary’s head snapped up. She regarded Dawson, eyes wide.

“That’s not what we meant, Dawson.”

There was a long rattle, then George’s hand went limp in hers. A sudden peace trembled in his face. Silence.

Mary cried out. She looked at the doctor, then back to her husband. He had suffered for twenty years.

“We will say no more of this.” She released George’s hand and drew herself up slowly. “The King is dead,” she said. “Long live the King.”

Sources used by the author in the above dramatic reconstruction of the death of King George V: 1. The Independent 28th November 1986; 2. Wintle J, Kenin R, Dictionary of Biographical Quotation. London: Routledge & Kegan Paul 1978.

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*Casual readers please note: Exit is a long-standing and responsible organisation, founded in 1980 to research and produce self-euthanasia literature. We do not publish advice on how to end your life online, or by email or in comments to the Blog.

A long time ago, some time in the 4th Century BCE, an important document was written codifying certain ancient rules of ethics. Attributed to the Hippocrates, a doctor was expected to swear by Asklepius, to teach medicine without charging a fee, he won’t provide pessaries for an abortion and, the bit so favoured by the anti-euthanasia lobby, “I will give no deadly medicine to anyone if asked, nor suggest any such.”

It all sounds very noble, even though, whatever the author of the Oath promised, there was no licensing of physicians in Classical times – anyone could treat a patient in any way they wished if the patient agreed. Supplying poison to murder someone was strictly frowned on, yet suicide was not uncommon in the face of serious disease. Aristotle and Pliny speci­fied diseases that were justifications for suicide because of the severe pain they caused. Poison was the favourite way of taking one’s life. The Hippocratic oath was something of a minority statement. Only in Thebes was suicide illegal. When suffering got too bad, it was generally better to get a poison to end one’s life from a physician than from a herbalist. Probably then, as now, a few doctors objected and wanted to distance themselves from such alleviation of suffering.

One cannot help but wonder how many professors of medicine refuse a salary for teaching? Or make a solemn promise to Asclepius? “Taking the Hippocratic Oath”. Few if any institutions still swear by the Hippocratic oath, or even find it easy agree on the ethical duty of a new doctor. The often-repeated phrase, “First, do no harm” doesn’t exist in the original Oath. But would it stand up to rational analysis?

Obviously one way of never doing any harm would not be to treat anyone in case something went wrong (and in modern America, in case of a lawsuit). In practice, doctors not only treat patients by balancing doing probably good against avoiding probable harm, use triage to see who to treat first, and give deadly medicine quite often – though carefully dispensed to kill cancer cells, bacteria, or simply kill pain. ‘Doing no harm’ is a starting point and actually the first rule of trauma care, proceeding in a methodical manner, gathering information and stabilising the patient.

Once the patient is stabilised and options for doing good arise, the next question that arises (and one of law) is, what does the patient want?

Contrary to what you are maybe expecting me to say at this point, I do not think that there is never a place for paternalism in medicine. A classic case that came up and reported in the medical press concerned an elderly woman who had a simple, easily curable cancer. She refused to go to hospital as she believed she would die there if she went. A new doctor seeing her ‘bullied’ her a bit and told her, “Get in that ambulance, right now!” She did, and was duly discharged after successful treatment. But that is an unusual case: while a doctor is an expert on what treatments can be offered, the patient is normally the expert on what outcome he or she would prefer.

To some, it appears ‘obvious’ (clearly not, as people on both sides of the debate think it is ‘obvious yet disagree!) Death, whether one’s own or someone else’s is not, in the general run of things, the most palatable of options. Yet sometimes it is the ‘least worst option.’

In Antigone, Sophokles states that nobody is so silly as to wish to die: ‘Who prays to die is mad.’ ‘No man is so foolish that he is enamoured of death.’ However, in another play, The Women of Trachis, he refers to the dilemma presented by assisted euthanasia: The protagonist Herakles, who is suffering from unbearable pain, asks his son, Hyllus, to help him end his life:

“Lay my body thereupon and kindle it with flaming pine-torch. And let no tear of mourning be seen there.”

Hyllus complains that in so doing, he will ‘become a murderer’ and will be showing disrespect to the gods. “What a deed dost thou require of me my father that I should become the murderer guilty of thy blood. … Father, father, how can you? You are asking me to be your murderer, polluted with your blood.” And Heracles replies:

“No, I am not. I ask you to be my healer, or healer of my sufferings, sole physician of my pain.”

It is perhaps easy to speak about ‘high principles’ in the abstract. Somehow seeing someone you love enduring a suffering that you, as a physician, could end, pulls at a sense of humanity in a different way.

Until physicians unite and have the courage to do the right thing, properly and within a good law, people will take matters into their own hands.

Classical philosophy, Socrates and stuff, has occasionally had the reputation of being rather dry. But could it actually have the power to get to the heart of our feelings about death and dying?

There are many studies that go far beyond my cursory reading of Plato, but I first open the Collected Works (a free e-book) at the Apologia, where Socrates defends his attitude to death in what seems a straightforward manner:

“… fear of death is indeed the pretence of wisdom, and not real wisdom, being a pretence of knowing the unknown; and no one knows whether death, which men in their fear apprehend to be the greatest evil, may not be the greatest good.”

It sounds very clever but somehow doesn’t quite reach the heart. Plato seems to embody Socrates as a speaker who provokes a response. Some contend that Socrates uses a set of strategies, not to eliminate his fear of death but to control it. In the Phaedo, Socrates says first a philosopher must completely avoid money and power. He must devalue relationships such as those with friends and family. Next, one should regularly rehearse arguments about immortality until one believes them, and also tell myths and stories about the afterlife to speculate about its benefits.

The chances of Socrates convincing his audience is seriously impaired when we consider reasonable human desires Most people after all want to form and sustain intimate relationships with friends, family and loved ones. They become emotionally attached, and this attachment increases their fear of death, Socrates suggests, because death serves as the ultimate threat to the continuation of personal relationships.

Neoplatonists, who came considerably later than Plato, developed much of his ‘higher’
philosophy into a system that would greatly influence several other schools of thought
including Gnosticism, Isalm, Christianity and Theurgy. They respected and acknowledged the truths expounded by Plato, but also looked for some more practical methods that could be used both by philosophers and lay people.

The Greek terms of Logos, Eros and Agape were refined and abstracted so they were
suitable both for polytheistic religions of the time and also the newly emerging
monotheisms, as well as their own apophatic, mystical, philosophical or magical practices (in the cases of Neoplatonists like Proclus and Iamblichus). Eros became the supreme principle of divine attraction between any two things (not merely the English sense of ‘erotic’), and the basis through which the universal order is maintained. It was only through this that the selfless love of agape could be achieved.

Through this lens, our relationships with others also become a way to realise who we are ourselves, just as any object (in physics as in persons) is defined in space and time by its relation to other noumena, and objects to which it is drawn or repelled. The over-riding and highest principle inherited by the Neoplatonists was beauty, which shows all things balanced in their correct (bound by Eros) relationship to each other.

The idea is that by defining our individual correct relationship to other people in our sphere, we may arrive at a sense of oneself almost through their eyes, and experience the beauty of relationship without attachment. It is a lasting gift to them, and maintains the beauty and goodness of the relationship within our own perception while decreasing the attachment, thus reducing the fear of death upon which Socrates had expounded.

It might not be possible, or even desirable, to attempt to convey complex philosophical ideas in a one-page newsletter article, but perhaps by inclining our minds towards beauty, whether it be seeking out the works of a great philosopher, a favourite uplifting poem, or the sense of beauty in one’s relationship with another person, one can feel a sense of knowing an almost everlasting beauty , that is not diminished by letting go . . .

The above article was taken from the current Exit magazine. If you are interested in our print edition, it is free to members. If you are interested in joining and supporting our work, please go to http://www.euthanasia.cc/new_app.html

Our current full colour magazine:

THIS ISSUE: CONTENTS IN FULLI’m not afraid asks why so many people don’t take out ‘insurance’ on knowing how to die peacefully.Ludovic Kennedy: Courage – An essay by the famous late campaigner for voluntary euthanasia.Alison Britton: Ethics in Europe – Professor Britton compares the ethics of euthanasia approaches in different countries.Quote/Unquote – some of our favourite informative, humorous or inspirational quotes about death and dying.Ruminations of the ancients – featured in this issue of ExitEuthanasia Blog.Pam Ferguson: Hastening Death – legal perspectives by the Professor of Law.Off the bookshelf – we review Michael Green’s Dealing with Death, Oliver James’ Contented Dementia, and in a ‘curiosity corner’, of ‘dangerously dead’, Elizabeth Hurran’s historical survey, Dissecting the Criminal Corpse.Your letters – regular news and views from members.Special feature on how thinking about death can increase happiness.Research: From terror to joy – Kentucky experiments in psychological scienceHumour – (since we don’t think death has to be morbid!)Self-deliverance books reviewed – we examine the features of our own publications together with lengthy reviews of the books by our friends, Derek Humphry and Philip Nitschke. Each fills a different niche and we look at the plusses and minuses (and we also invited feedback from the authors).Challenges & progress – diversity and congruence in the self-deliverance literature.Paralympic Mariecke Vervoort – the Paralympic star’s personal views on euthanasiaThe Flickering Light – reviews of two movies touching on positive attitudes to death and dyingMore from our postbag – an extended reply on a number of issues from the Dignitas organisation in SwitzerlandTerminal fasts: Jains, science & law – advantages and dangers of fasting to death (voluntarily refusing food and liquids) with a criticakl look at teh science.

ExitEuthanasia Blog, in accordance with UK laws, does not offer information online or by email that could be construed as advice on committing suicide. Technical information on such matters is reserved for our print publications (click ‘Publications’ in the top menu for details).

No-one can really feel the pain of another when a loved one dies. Or the the moment that another experiences and feels in the minutes and seconds before that person dies. But does it have to be such a bad thing?

London’s famous Southbank is launching a new event, How Do We Live With Death from 22nd February to 25th March, it asks, “Does modern society distance us from our own mortality? And how are we able to live with the death of a loved one without the promise of seeing them in an afterlife? Death and taxes unite us all, so join us for an exploration of the way that death affects our life, an issue with which thinkers, artists and composers have long struggled.”

Exit approaches the question in many ways, and with our motto, taking away the fear of death. We believe there are both physical and emotional challenges to be surmounted, as well as that area that some call spiritual, some call philosophical, or some would simply say, “getting my head round it”.

Physical questions that can be covered include how best to approach one’s illness realistically in terms of treatments, making what is left of life worthwhile for as long as that is possible. Knowing what symptoms can be treated successfully, and which ones mostly can not. Knowing how to get the best out of terminal care. And the aspect we are most associated with (though not our only concern), how to draw things to a close a bit sooner rather than a bit later. Even that knowledge can be empowering. We don’t make grandiose claims about a magic pill, or that it will be easier or harder than it sounds: we just research and publish the science.

The emotional aspects are just as important, how we cope, how our loved ones will cope, how we should tell people. (We deal with these too!) But the question most people will discuss is, “How do I live when it sinks in that I am going to die?” – a question that becomes ever more pertinent as we enter later years, as serious illness looms, and as friends or family members die before us. It is something we can only put off for so long. Facing the inevitable prospect is probably better than avoidance, but is it possible not simply to make it a negative but to make it an inspirational positive?

In coming months we hope to share with our Exit Euthanasia Blog readers some excerpts from our print magazine on this very subject (please note that we do not publish precise instructions on self-euthanasia on the Blog, but provide updates within the awareness that the Blog goes to a general audience of all ages).

The Southbank Centre is correct in that Western society distances us from mortality, it distances us from death. A little while ago, I interviewed a member who had embraced the lifestyle of Nepal. One of the main features she spoke of was how death was so much a fact of life. Biers were carried in the street, cremations performed on an open pyre. Death was never far away, but not in a bad sense. Ancient Egyptian Pharaohs commenced work on their tombs the minute they had ascended to the royal throne: the idea that the “heart was weighed” after death was a guiding principle in life, each action to be performed with Maat, an idea of justice and balance, so that one might set an example in all things. A much publicized tale from Bhutan recently by travel writer Eric Weiner explained the habit of the Bhutanese in thinking about death “for five minutes every day” as a cure for panic, psychosomatic problems, or simply lack of contentment with life. Socrates and the Platonists of Ancient Greece found that much fear of death was rooted in personal relationships that would not be continued. To counter this, one can dissociate from relationships and then re-enter them as part of the joys of life, yet with an attitude of balance, loving appropriateness (or the Egyptian maat).

The Southbank Event may well have a strong emphasis on Christianity, which is one of the common threads for most people in the U.K., but there will be “talks, panels and debates covering topics such as whether we have the right to die, burial rites, apocalyptic religions and the way to immortality.” Panelists include the Bishop of Leeds and the London Philharmonic Orchestra is showcasing Berg’s Violin Concerto, dedicated to ‘the memory of an angel’, which “conveys a bottomless depth of personal loss.” They also perform Penderecki’s St Luke Passion, a work which “struggles and laments towards redemption.” There is, however, a “Right To Die” debate on assisted dying (1:00 pm, 4th March), a ‘Death Cafe’ (same day) and other talks, discussions and events that increase awareness of mortality. Does it sound like the upbeat, constructive approach for instance of many TED lectures on the subject? Perhaps not at first glance: but given the Southbank’s formidable reputation for great events it will quite possibly be a huge success! Let us know your thoughts.

To get free updates on this Blog by email, or to find our publications, use the right hand column and click on subscribe or the links to our books, or the top menu on publications for more information. Exit works in the self-deliverance movement independently but as part of a non-competitive environment. We review similar work by other people and organisations to demonstrate both diversity and congruence. Our work is supported by extensive (published) scientific analysis but our only funding comes from donations and memberships.
(You can also donate using the button in the right hand column).

We salute some of the beautiful friends-in-spirit who decide about their Exit this year.

Betsy Davis threw a farewell party with friends and family in July. It was her way to say goodbye before becoming one of the first California residents to take life-ending drugs under a new law.

Betsy, a 41-year-old artist with ALS (Lou Gehrig’s disease) emailed the invites with a special message: “These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.” And she added just one rule: No crying in front of her.

Ms Davis Davis planned a detailed schedule for the gathering, including the precise hour she planned to slip into a coma, sharing her plans with guests in the invitation.
One woman brought a cello. Someone else played a harmonica. There were cocktails, pizzas, and a screening in her room of one of her favourite films, “The Dance of Reality,” based on the life of a Chilean film director.

Paralympian Marieke Vervoort says planing her own euthanasia is enabling her to live longer. The power to take her own life, she says, is really what’s keeping her alive. A silver and bronze medalist, Vervoort says that knowledge, that she can have a safe and easy death, gives her the strength to keep going.

Her silver medal in the T52 400m in Rio de Janeiro came after 30 hours of violent sickness and a day on a rehydrating drip in the Paralympic village. Her bronze in the 100 metres came after a bladder infection had sent her temperature soaring. 37-years-old, the Belgian wheelchair racer suffers so much pain she wakes up her neighbours by screaming in the night. Marieke Vervoort has a progressive, incurable spinal condition, diagnosed when she was 21, that ravages her body. Her fiercely defended independence dwindles. She has visits from nurses four times a day, and also an assitance labrador, Zenn, who fetches items for her, helps her dress and supports her during epileptic attacks or when she is crying.

“When I’m happy, she’s happy,” says Vervoort. “When I’m mad, she’s scared, and she goes to sit in another part of the house so she’s not bothering me. When I’m crying, she’ll come to lie down with me, lick my face, hug me. When I’m going to have an epileptic attack, she pushes her head between my knees. She is saying to me, ‘Marieke, you have to lay down. Go to a safe spot because something is going to happen to you.'”

Triathlon had become her passion when the disease made her reliant on a wheelchair. She was world champion twice, but in 2008 her condition deteriorated so much she had to give up the sport. It was the lowest point in her life. The pain was agonising, the loss of independence insupportable. She told her friend she wanted to kill herself. “She said, ‘there’s no point in living, no point in going on because it’s too hard, it’s too bad.'” It was Marieke’s coach and therapist that recommended she speak with Dr Wim Distelmans, a leading palliative care expert, and who suggested another option: that of euthanasia. She decided to sign the papers.

“If I didn’t have those papers, I wouldn’t have been able to go into the Paralympics. I was a very depressed person – I was thinking about how I was going to kill myself,” she explains.”To me, death is peaceful, something that gives me a good feeling.”

“All those people who get those papers here in Belgium – they have a good feeling. They don’t have to die in pain. They can choose a moment, and be with the people they want to be with. With euthanasia you’re sure that you will have a soft, beautiful death.”

“I prepared everything. I wrote to every person who’s in my heart. I wrote to every person a letter when I could still do it with my hands,” she says. “I wrote texts that they have to read. I want that everybody takes a glass of Cava, [and toasts me] because she had a really good life. She had a really bad disease, but thanks to that disease, she was able to do things that people can only dream about, because I was mentally so strong. “I want people to remember that Marieke was somebody living day by day and enjoying every little moment.”

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Print subscribers were treated to our first all-colour issue last month and feedback so far has been great!

We have to balance costs carefully so every penny we spend has t0 be justified under the benefits it brings to our members. A colour magazine is more expensive than a black and white one, but when we took it as a proportion of overall costs including postage the difference turned out to be miniscule.For legal reasons, we can put far more explicit information in the magazine than we can in the online Blog, but here’s a round up of the latest one (Volume 36 No.1) for those who are interested –

Helium climbs back The current situation analysed and the likelihood of helium tanks being ‘diluted’ with air. USA vs Europe.Quote/unquote A round up of moving, inspiring or eye-opening quotations from the best in literature, the medical press and philosophy Advancing discussion (by David Donnison) The illustrious social science professor from Glasgow looks at some options for real progressStanding firm (by Ken Jones) examines meditation techniques clinically proven that can help in facing inevitable death in the best possible wayOff the bookshelf Our round-up of some books of interestUnsung birth of the helium method Helium brought a new era to self-euthanasia, but who brought us helium?Rising costs of death You’ve worked out your insurance policy and how to take things into your own hands should the need ever arise: but have you factored in the cost?Eavesdropping on your decisions? Emailing someone about your end of life decisions? When government invasions of privacy can mean you door can be forced open.The good news on helium A run down of what’s what, and a simplified approach to nitrogen euthanasiaThe Carloway decision Technical analysis of the Scottish legal decision and what it really meansDeath as inspiration A famous motivational speech on why we shouldn’t fear deathLiving wills 7-step scenario A compact reference guide to approaching this important document, condensed from our new membership packAn organic burial suit Really? where art meets dying wellNitro USA Some statistics on the American take-up on the ‘new nitrogen method’Private dying & staying safe How to protect yourself from prying eyesAGM report It’s feels quite informal, but follows a strict methodology to ensure that all cost undertakings are measured in terms of benefits to our paid-up print membersHeart of Darkness wrestling with death through one of the most powerful novels of all timeNeedless inconvenience (H28) They make it sound so simple (yes it can be – except when it goes horribly wrong!)Self-deliverance costs compared A rough answer to financial aspects

The print magazine is aimed at mature adults who want more specific, practical information to look at the long term of having a safety strategy, a “key to the door marked ‘Exit.'” If it is news and updates you are looking for, those are available free from many sources, including this Blog (please scroll down the right-hand side for links to online news information from professional bodies and sister organisations). You will also find a search box to look for specific blogs on particular subjects and some links to various laws around the world.

A big thank you again, both to out Blog and Print subscribers, for all your feedback and support!

ExitEuthanasia Blog has been receiving emails about eleven short words spoken by this man on 19 February this year.

“It is not a crime ‘to assist’ another to commit suicide.”

Really?

61-year-old Colin Sutherland was a graduate of Edinburgh University and was admitted to the Faculty of Advocates in 1977. His appointment as Lord President and Lord Justice General was announced on 18 December 2015. That makes him Scotland’s most senior judge.

Rather less eye-catching were the next few words which were:

“However, if a person does something which he knows will cause the death of another person, he will be guilty of homicide if his act is the immediate and direct cause of the person’s death.”

He then goes on to say that the crime may be treated as murder or culpable homicide depending on the individual circumstances of the case.

Lord Carloway is not only repeating the assertion of the Procurator Fiscal in the consultations over the failed Assisted Suicide bills brought by Margo Macdonald that “the law in Scotland is perfectly clear”: he is upholding the opinion of a previous court last year.

This was another “what if” question, trying to work out in advance if someone would be prosecuted if assisting a suicide in Scotland. A similar attempt in England resulted in the Director of Public Prosecutions issuing helpful guidelines on factors that would tend towards – or against – prosecution of cases.

But is the judgement helpful? On the face of it, yes. It seems a lot more clear-cut than in England and Wales. But it is only a formal opinion. It is not a judgment on a particular case, either actual or in the future. More than that, the opinion was basically to say whether the failure by the Lord Advocate to adopt and publish a policy identifying the facts and circumstances which he will take into account in deciding whether or not to authorise the prosecution in Scotland of a person who assists another to commit suicide breaches human rights law. The appeal judges, headed by Lord Carloway, decided it did not.

So that is the position: the Lord Advocate is not forced to publish guidance (as the Director of Public Prosecutions did in England). The law in Scotland is “perfectly clear.” (It could actually be argued that the law in England & Wales was “perfectly clear” without the Guidelines, but now England & Wales has guidelines and Scotland still does not.

In England and Wales, “many factors are taken into consideration” and are enumerated. In Scotland, “many factors are taken into consideration” but are not enumerated.

As we read their Lordships comments, it would seem that they repeatedly come close to giving guidance only to throw it away again.

Mr Ross, a terminally ill man who has since died, had written to the Lord Advocate to request specific guidance on whether anyone who assisted him to commit suicide would be prosecuted. The Lord Advocate said that any incident involving a person who assisted another to take his own life would be reported to the procurator fiscal as a “deliberate killing” of another.

Said Lord Carloway: “Exactly where the line of causation falls to be drawn is a matter of fact and circumstance for determination in each individual case. That does not, however, produce any uncertainly in the law.” He continued, ““… other acts which do not amount to an immediate and direct cause are not criminal. Such acts, including taking persons to places where they may commit, or seek assistance to commit, suicide, fall firmly on the other side of the line of criminality. They do not, in a legal sense, cause the death, even if that death was predicted as the likely outcome of the visit.”

Lord Drummond: “The statements of policy make it clear that exceptional cases may exist where a prosecution will not be appropriate; in such cases the general discretion of the prosecution authority will be relevant. Nevertheless, it is apparent that the norm is to prosecute. … It is of the nature of exceptional cases that they are hard to predict. To expect an enumeration of such cases would be wholly unreasonable. For this reason I am of the opinion that the Lord Advocate’s policy clearly meets the standard of reasonable certainty that is implicit in the requirement of legality”.

Some assisted suicide campaigners have hailed the opinion as a ‘victory’ and others as a ‘disappointment.’ Rather like asking if the glass is half full or half empty, Exit believes it is neither. (We have included the legal opinion in full, both in the footnotes to this Blog and in the right hand panel for reference, along with other legal instruments of interest.)

A quick note to Exit Members, our print subscribers:The new magazine is a little late, due to computer problems…
but we are working on it! The new issue hopefully won’t be long!

Addendum. It is perhaps worth pointing out that Exit has never been of the opinion that such challenges were valid challenges in law. The opinion of Lord Carloway was perfectly correct in legal terms. For a fuller explanation, readers are referred to 6th Report, 2015 (Session 4): Stage 1 Report on Assisted Suicide (Scotland) Bill and the points on Assisted suicide and the existing law, paras 23-42 and the conclusions which follow them.

Exit takes the position that a challenge to change existing law should be made on the basis of exceptions to the rule of homicide. (See our draft bill template, prepared in association with Glasgow University.) Such a change would be a matter for Parliament, but the arguments put forward to the Scottish Parliament, in our opinion, have repeatedly been ill-conceived, resting on fallacious criticisms of the law as in the case recently before Lord Carloway and in the bills brought by MSP Margo MacDonald. It has been the case, for many years, that proposers of bills come to Exit after they have drafted their bills instead of beforehand. This puts Exit in a difficult position as we wish to support them in spirit but our advice at that stage would have to be “re-write them completely.”

For further information and resources on how Scotland and the UK handles cases of assisted suicide under existing law, please see the legal sections of our publications.

At its core, perhaps we can say death is two things: what it means to the person who dies, and what it means to the people who will remember. Two days ago in Austin, Texas, a young student, 20-year-old Richard Truong, died. Not particularly quickly, not particularly painlessly, but by his own hand. He had followed the fad for “chemical suicide” – a method of producing hydrogen sulphide gas by mixing household chemicals. This rather extreme example is used to highlight the often complexity of self-dying, and is not as unrelated to the peaceful exit approach favoured by followers of this website as it might at first seem.

“This is not an uncommon method of chemical suicide,” said the attending fire chief. “You can search on the internet to see some of the different ways this is done.” As he died, Richard also hospitalised six other people injured by the fumes and a further five that needed treatment for exposure to the gas. As he was in the process of cardiac arrest as emergency services arrived, it can reasonably be assumed that he didn’t get the mixture ‘quite right’ or experience the instant ‘knock-down effect’ for which he had hoped. It is likely that he suffered.

A ‘good death’ is sometimes described under three headings. One is CLINICAL: that the death is swift and relatively pain-free. Another is CLOSURE, which relates to the person’s relationships with others. A third is PERSONAL CONTROL — control of what is happening and maybe also being able to communicate before dying.

Someone who dies as a result of sudden depression, as it seems Richard may indeed have, most likely has not experienced closure. There are many things one might wish would have happened. One cannot imagine the pain now that his family must be experiencing. But Richard’s death is a lesson to all of us in terms of closure. In whatever way one dies, one’s death is a statement of one’s life. It is worth getting things right: the right time and the right way. It will mean something to somebody.

Seeing things ‘with a second pair of eyes’ can also be enlightening. Not just for the memory one creates but to see oneself as if as another person who is looking on. Was he or she getting things ‘right’? Taking care enough to plan properly? To focus enough, in the last statement of life itself, to do one’s best?

Last year, there was a panic over helium supplies. The situation seems now more or less stabilised (we are preparing an update for our print magazine and later for this Blog); yet in the interval we have seen a rush to seek out drugs which the movement had once discarded as dangerous, or a rush to recommend drugs that require great care.

People sometimes write to Exit and say, “You seem to recommend this, but someone else recommends something else: which is right?” All we say is, please examine the evidence. If you genuinely need this information to prepare for an unknown future, to give you courage to face a terminal illness, or have reached extreme old age, then there is time to consider options. There is time to look at evidence.

There is time to be as sure as you can possibly be.

Notes:

Hydrogen sulphide
Although a painless death is sometimes possible, Exit does not recommend it. A report of a failed hydrogen sulphide attempt is reported here, and the science discussed in our publications and briefly elsewhere on this Blog. 1,2,3.

A good death
Research on the factors considered to be important in a good death are examined in a study that can be found here.

Methods of self-euthanasia
are detailed with extensive analysis and supporting evidence in our publications (see side-bar, Amazon or good bookshops). Exit does not give one-to-one advice on methods of suicide by phone, letter or email, or in any manner outside of its publications, members’ magazine and occasional full-day workshops.

Picture
John William Waterhouse [Public domain]. Sleep and his Half-brother Death is a painting by John William Waterhouse completed in 1874. It was painted after both his younger brothers died of tuberculosis.

Death: the Human Experience is available now and until March 13th 2016 at the Bristol Museum & Art Gallery.

With spectacular artefacts, it asks visitors to consider the science, ethics, attitudes and process of death, as well as the variety of ways human remains are used and the importance of end-of-life choices in contemporary society.

An interesting way to get past the taboo of thinking of death is to confront it in a colourful way. The exhibition includes mummified body parts, coffins from around the world, Japanese watercolours, mourning clothes, grave goods and much more. They show how death has been treated from the earliest human civilisations to modern day societies and pose questions including, when is death; what happens to us after we die; and what symbols do we use to understand death.

Councillor and Assistant Mayor, Simon Cook explained, “Around the world, different cultures have expressed their relationship with death in a myriad of fashions from the visual Mexican Day of the Dead to the audible lament of the Australian Aboriginal death wail. Yet in recent times we have seen a reluctance to engage with the subject, something I hope this exhibition will help to change. death: the human experience will provide visitors with an opportunity to encounter the death practices and beliefs of many world cultures whilst also being encouraged to reflect upon their own thoughts on death and the dead.”

The displays include a re-creation of a room at the Dignitas flat near Zurich. Called death: is it your right to choose? it is intended to encourage debate and discussion around end of life choices during a time when end of life laws and guidance are undergoing scrutiny. The reproduction of the room is surrounded by displays relating to the wider spectrum of opinions on Assisted Dying including personal testimonies.

A variety of experts including palliative care doctors, university medical ethics professors and Dignitas themselves have been consulted during the development of the display, as well as organisations such as Dying Matters, Healthcare Professionals for Assisted Dying, and Society for Old Age Rational Suicide. Visitors to the installation will be encouraged to explore their own feelings on the subject, guided by medical, ethical, philosophical and emotive elements, before giving their response on whether assisted dying be made legal in the UK.

All the knowledge in the world won’t help if one is afraid of the moment when “the lights go out . . .”

What does it have to do with self-euthanasia you might ask? Are there displays of helium hood kits and demonstrations of the compression method? Well, no (and at least not planned, as far as we know at the time of writing). But the answer of course is fairly simple: quite apart from the fact that not everyone can afford £10,000 to have assisted suicide in Switzerland – all the knowledge of self-deliverance in the world won’t help if one is still afraid of dying itself, of the moment, “when the lights go out.”

For two and a half years, documentary filmmaker Fadi Hindash followed a psychiatrist as he assists one of his patients with her suicide. It is her story, as well as that of her doctor, facing the reality that helping his patient die is the only way to save her. Fadi Hindash is an award-winning filmmaker of both fiction and documentary work.

The film-makers have now released a very moving extended trailer that our readers may enjoy (please click on the photo or the link at the end of this post).

One of the complications in the movie is that this is a film about the before-during-and-after an assisted suicide, but it involves the controversial area of mental suffering.

Mrs. L suffered severe anxiety disorder all her life. She spent her days alone, heavily medicated and forty years of mental illness isolated her to the extent of having no family or friends. That lonely existence is in complete contrast to Dr. Polak’s life. His is packed with friends, grandchildren, birthday dinners and colleagues.

Despite his active social life, Dr. Polak has built an emotional wall around himself. He is a man who cherishes his freedom above all else. But as he witnesses Mrs. L embrace death without fear, he begins to re-evaluating what freedom means to him personally.

As we know only too well, independent films like this take money to finish, so Fadi Hindash has asked Exit to share with our readers some of the ways you can support the final editing stage (details also in the link).“But isn’t Exit seeking funding to complete Exit’s own movie,” I here you ask? Indeed we are: but can we in all honesty ask you to support our project and ignore another which may be equally worthy? Have a look . . .

Instead of a set of rules where “one size fits all”, or wordily-phrased “rights”, psychologists have looked at a different model: one of, “Is this an appropriate death?”

The most common scenario, where laws are proposed based on certain check-boxes being fulfilled, is deeply flawed. “Two physicians must agree” – yet if the doctors in the area all happen to be opposed on principle, then they are not likely to agree. “Where the patient has six months to live” – and quite apart from the difficulty of determining this, we know that most major headline cases were not terminal: Debbie Purdy, Tony Bland, Terri Schiavo, Ramon Sampedro. Like these cases, when you have a set of fixed rules, the future will often surprise with one that feels morally right but doesn’t fall within the strict ‘rulebook.’

Exit’s response was to commission a University study on feasibility. The researchers found that the best type of law reform, instead of ‘legalising’ certain types of assisted suicide outright, would simply be to enact powers to the Courts that would allow them to make exceptions to the rule against assisted suicide.

The confusion over law-making stems not from how and when assisted suicide should be allowed, but something more basic: the question of, what is an appropriate death? The indicators would provide clues for all possible deaths, not just assisted suicides.

Psychologist David Lester, from the Center for the Study of Suicide in New Jersey, built on the work of Avery Weisman and Thomas Hackett in considering the sort of criteria that lead us to conclude that a death is ‘appropriate.’

The role of the individual. There is a temptation to just call this ‘autonomy’ whereas it may not be quite that simple. A person struck by lightning has no autonomous role in the death, whereas a suicide, whether through very understandable causes or through a lack of social support and a place to live, might or might not be judged ‘autonomous’ – depending how in control we think that person is. But if a person does play a large role in their own death, that would indeed be a factor to consider.

Consistency in lifestyle. One person might always have been of the outlook, “Just leave it up to the doctors.” If they suddenly changed their mind and sought assisted suicide, it would seem less consistent than someone who had firmly believed in their ‘right to die’ for a long time.

Timing. We use phrases like, “It was his time.” Someone who is very ill, without the prospect of decent recovery, or someone who is very old, may seem more convincing to us than a young healthy person.

What about the kind of death? Someone who dies alone and isolated, unable to leave their house, suggests to us something inappropriate. Violent deaths such as road accidents also seem inappropriate (although Ernest Hemingway’s suicide by firearm seemed at least consistent with his lifestyle). Natural death, when a person’s body just gives up, usually seems appropriate. Psychological death, when the brain has completely ceased to function but the body goes on, can in many ways be sensed as death but does not have the finality of physical death. Assisted suicide in cases where the above conditions are recognised tend to be seen as more appropriate than when such conditions are absent.

Exit euthanasia blog analyses end of life issues, euthanasia, self-deliverance and assisted suicide. .........................................................
Exit does not give you a "quick answer": it gives you a responsible one, based on multidisciplinary study and embodying the latest research from around the world since 1980.
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Please note the blog does *not* include detailed "how-to" information on methods of self-euthanasia or rational suicide. (see "About Exit" on the main menu.) But we publish the most extensive, scientifically supported and detailed information from any source you are likely to find.

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THE SAMARITANS. If you are suicidally depressed, we urge you to visit The Samaritans for confidential, emotional, non-judgmental support. (Please click on the photo.)

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“Five Last Acts, at over 400 pages, marks what may be the most comprehensive guide to self-deliverance techniques available.”

Use of helium, drugs, compression, plastic bags, starvation and other means, as well as other key resources including authoritative information on the legal position. It's comprehensive analysis and step-by-step explanation of methods of self-deliverance is far-reaching and probably unrivalled, both for the individual seeking peace of mind and for other researchers in the area.

Main link (Amazon U.S.):
http://www.amazon.com/dp/1453869379/

Also available from Amazon uk:
http://www.amazon.co.uk/dp/1453869379/

The complete reference, over 800 pages, The Exit Path, is also available. Please click the image below to order, or see the Publications page at the top menu.

For even more: Five Last Acts – The Exit Path (2015 edition)

● Five Last Acts: The Exit Path 2015. ● 822 pages. ● The world's first and most authoritative book to include self-euthanasia with nitrogen ● over 100 illustrations and ‘how-to‘ diagrams. ● Over 1000 references. ● tables & charts ● Tips and checklists ● scientific evidence. "This is quite a tome! But for a very detailed and clear examination of all the background to the technical intricacies of the movement for the right to choose to die it is in a class on its own. This book is for the science-minded DIY person. A most unusual book." – Derek Humphry

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The first purpose of this blog is to update our members and supporters. We'll also post some news stories of interest. Anyone can join, read the posts, and send comments or questions on specific stories.

The most extensive volume on self-deliverance ever published, Five Last Acts: The Exit Path covers every method in encyclopedic detail, answering questions on different approaches for researchers and lay-persons alike. The Exit Path contains all the material from Five Last Acts II plus new and exclusive material.

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Who are EXIT?

Exit was formed in 1980 with the specific purpose of researching and making available reliable information on how to end one's life if faced with unbearable and unrelievable suffering. There are many excellent groups that use the name Exit worldwide - and although imitation is the sincerest form of flattery, we would point out that they are not connected to us. We believe the best information you can obtain on self-deliverance is from our books, newsletters and workshops - you will not find those produced by other groups to be the same.
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When it all comes to an end

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Whether a person is interested in the reassurances that Exit's literature can offer or not, each of us has to face the moment of death one day. "When it all comes to an end" examines what we can do to face the last moments with equanimity, whatever our situation. It is for your personal use and may not be published elsewhere or modified without permission.

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